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Signs of pain? Hours really do matter to prevent nerve damage. Crate at once. Get to vet for diagnosis & medications.


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You can find board-certified neuro (ACVIM) and ortho (ACVS) surgical specialists at university vet teaching hospitals  and in private hospitals.




A quick review of the two treatments for a disc episode

Conservative (medications + rest) — Surgery to remove disc material

Conservative or Surgery

The information on this page was reviewed for correct medical  information by Dr. Isaacs, DVM, (Neurology (ACVIM)

When surgery is a consideration:

  • ▪️If your dog can’t walk OR with STRICT rest, neurological functions worsen and are lost (legs and bladder control)
  • ▪️If STRICT rest is employed and after several attempts to go off of the anti-inflammatory, the pain returns
  • ▪️If 100% STRICT rest had been employed and pain medications have been adjusted (dose, frequency, and mix of pain relievers) yet the pain can’t be brought under control
  • ▪️If a dog is experiencing similar signs of neck or back pain, or mild neurological deficits for the 3rd or 4th time, meaning it may be the same disc is involved.

As damage to the spinal cord increases, there is a predictable stepwise deterioration of functions.

When the body begins to self heal nerves, often it follows the reverse order:
  1. ▪️Pain caused by the tearing disc & inflammation in the spinal cord
  2. ▪️Wobbly walking, legs cross
  3. ▪️ Nails scuffing floor
  4. ▪️Paws knuckle under
  5. ▪️Legs do not work (paralysis, dog is down)
  6. ▪️Bladder control is lost (leaks on you when lifted)
  7. ▪️Tail wagging with joy is lost when specifically doing some happy talk to your dog
  8. ▪️Deep pain sensation, the last neuro function, a critical indicator for nerves to be able to self heal after a surgery or with conservative treatment..
  9. ▪️If surgery is not an option (for whatever reason) then the best option is conservative therapy. Surgery can still be successful in the window of 12-24 hours after loss of deep pain sensation. Even after that window of time, there can still be a good outcome. Each hour that passes decreases that chance. Precious hours can be lost with a vet that gets DPS wrong. If surgery is an option for your family get to a neuro or ortho where ER hours are typical night and day.
General vets who may not see enough cases of IVDD daily, may not be proficient in giving the neuro exam and correctly interpreting what they see. Therefore precious time can be lost in wrongly identifying deep pain sensation. Only take the word of a board certified neuro (ACVIM) or ortho (ACVS) about DPS.

Financial and  locating a surgeon

No- or low-interest credit for veterinary costs can be obtained from Care Credit. You find out online if you qualify. Surgery on the spinal cord takes a well-trained surgeon for this most delicate and tricky of surgeries. You can find board-certified neuro (ACVIM) and ortho (ACVS) surgical specialists at university vet teaching hospitals and in private hospitals. Find Veterinary surgeons (ACVS) and neuro surgeons (ACVIM) here: http://find.vetspecialists.com

Surgery compared with conservative treatment

Surgery immediately removes the offensive disc material

and stops the pressure on the spinal cord. Immediate neuro improvement may or may not come during the 6 weeks of post-op rest… as nerves in many cases take more than 6 weeks to heal… in fact there is no time limit for nerves to heal. There may be temporary neuro setbacks caused by the swelling the surgical procedure itself causes. Surgical swelling likely will subside in two weeks so that the true direction of nerve healing can better be seen.

Conservative treatment uses a steroid or a NSAID to resolve swollen tissue

around the spinal cord to relieve pressure on nerves. With time the hope is that the disc will recede or be re-absorbed enough to no longer aggravate nerves. Both the damaged disc and nerves is something the body does to self heal.  Discs take about 8 weeks to self heal. Nerve healing may range in weeks to close to a year out.

Quick overview: conservative vs. surgery

The following has been compiled via observations surgeons and IVDD knowledgeable vets suggest for treatment.  Not all veterinarians will treat the same way. Follow the advise of your board certified surgeon when surgery is to be considered

Surgery

  • ▪️Surgery is an invasive treatment with trauma to the body and includes surgical-associated risks; no guarantees of return of neuro functions.
  • ▪️It immediately removes the offending disc material and the pressure on the spinal cord.
  • ▪️Surgery results can be very successful if performed early on a downed dog and by a board certified neruro or ortho surgeon
  • ▪️There is a window of 12-24 hours after paralysis plus loss of deep pain sensation that surgery could still be successful.
  • ▪️The more hours that pass after 24 hours the less chance for full recovery
  • ▪️Nerves are the slowest part of the body to heal. Nerves can take weeks, months or even a year+ to regrow and return function.
  • ▪️Because offending disc material has been removed PT can be started as soon as the surgeon directs during 6 weeks of post-op recovery suite rest.
  • ▪️Acupuncture or laser light therapy helps to relieve pain and stimulate nerves to heal, it can be started at any time.
  • ▪️Costs vary widely across the country from $2500 to $8000 for a CT, MRI or myelogram, the surgery and the hospital stay of 2-5 days.

Conservative Treatment

  • ▪️Is not invasive, avoids surgical risks; no guarantees of return of neuro functions.XXXXXxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxXXXXXXXXXXXX
  • ▪️Good prognosis with mild symptoms and even those with deep pain sensation still intact may be able to recover nerve function.
  • ▪️Depends on an anti-inflammatory to reduce swelling in the spinal cord. Some dogs can get the swelling down in a couple of weeks others need a steroid for more like a month. Glucocorticoids are synthetic versions of the body’s naturally occurring steroid, cortisol.
  • ▪️Steroids are basically the most powerful anti-inflammatories when dealing with IVDD. Most often used when there has been loss of neuro functions (i.e. legs, bladder control)
  • ▪️NSAIDs (non-steroid anti-inflammatories) are also used most often when neuro functions are intact and there is pain only.
  • ▪️Depends on owners commitment to time of 8 weeks of little movement to allow the disc itself to heal and form good scar tissue, waiting til after STRICT rest before any active PT rehabilitation is approached.
  • ▪️Nerves are the slowest part of the body to heal. Nerves can take weeks, months or even a year+ to regrow and return function or laser light therapy helps to relieve pain and stimulate nerves to heal, it can be started at any time.
  • ▪️Medications can be low in cost by using generics rather than brand names.  STRICT rest is free.
  • ▪️There are other diseases that can mimic a disc problem, your vet will rule those out with appropriate tests.

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Minutes/hours really do matter. Contain the dog to limit movement of the back. This prevents worse disc damage and lessons the potential to loose leg functions. Get to the vet asap for a diagnosis and get the meds started.


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Assist your dog to relax in a recovery suite

Helpful tips  for adjusting to a recovery suite (Pack N Play, wire crate, ex-pen). 

A suite with room service!

Make the rest period go smoother for you and your dog!

Adjusting to a recovery suite

Helpful tips and ideas for adjusting to a recovery suite (Pack N Play, wire crate, ex-pen). Make the rest period go smoother for you and your dog on conservative treatment or post-op rest.

by Lori Kobayashi, APDT (Association of Pet Dog Trainers)

If your dog is on Conservative treatment (medicines and rest) or post-op crate rest, and your dog is not happy about being in the recovery suite, you’ll have to try a few different things to make them more comfortable with being confined. If your dog is making a big deal about being in the crate, I highly recommend not feeding your dog their meals from a bowl. All of his meals will be fed as part of his crate adjustment training.

recovery-suite-living-room

Some dogs prefer to have the recovery suite in a central location in the home where most of the activity in the home happens like a kitchen or living room. Some dogs do better with the suite located to a more quiet area of the home like a bedroom or finished basement. Try different locations to see where they seem the most settled down. Ideally, have multiple suites in multiple locations. One in the main living area and one in the bedroom is a typical home setup.

Tips and hints to extinguish unwanted behavior

If your dog is not happy and begins barking and howling, give no eye contact. Ignore them, don’t yell at them, don’t say “no”, “quiet” or anything else. They are barking for attention- and ANYTHING you do is giving them attention. Turn your back, go to another room, no talking. When calm, use your clicker or verbal marker like “yes” to show the dog that being calm is the correct behavior and proceed to give a treat and attention. As soon as there is barking and whining again, leave. Soon the dog will learn that being quiet gets treats and attention, and that barking and whining makes you go away. You should use all of your dog’s meals to reward your dog for being calm in their suite. If your dog has a cervical disk injury, attach a bowl to the side of the the suite at the proper level, and drop the food/treats into the bowl.

Other options to calm

If your dog doesn’t calm down and continues to bark/whine when you leave the room you can try a few different things.

Cover the suite with a blanket. If your dog pulls at the blanket , put a sheet of wood or cardboard the top of the suite that is slightly larger than the top so the blanket doesn’t drop down over the sides

Sit next to the covered suite with your dog’s food and some high-value treats. As SOON as your dog is quiet, click and feed your dog a treat under the blanket in the suite. The clicker is useful in this instance because if your dog is barking/whining a lot, it enables you to mark the exact moment of “quiet” which may be very brief. If your dog starts barking/whining again after you click, STILL feed them the treat but put the cover over the suite again.

You should start to see an increase in “quiet” periods if you do this for many repetitions. Once your dog is quiet for 20-30 seconds, start to lift the side of the blanket closest to you. If they remain quiet, click/treat. If they bark, don’t say anything- just put the blanket back down and wait for quiet. Repeat. The key to this is patience, and complete silence from you when your dog is barking.

You also want to keep your verbal praise low-key when your dog is quiet. It is fine to tell them “good dog” and “good job” etc. — BUT remember, we are trying to keep them calm and if they get all excited when you praise them, we may be undoing all the work we’ve done.

You should start to be able to uncover the suite for longer periods of time. Once your dog can be quiet with the suite uncovered for about a minute, leave the suite uncovered and walk out of the room. If your dog stays quiet, IMMEDIATELY click, return and feed a treat. If your dog starts barking, return and cover the suite. Wait a few seconds and try again.

Try to work on calm crate behavior at least once a day (with their meal), and preferably twice a day. The more sessions, the better.

Suite in the bedroom. If your dog is used to sleeping in the bed with you, try to put a wire crate on a sturdy table or chair next to the bed so the crate is at eye level with you when you are in bed. This may help some dogs be able to see you, and feel like they are closer to you.

Play relaxing music for your dog. There have been scientific studies that have shown the calming effect of some types of music on dogs (and people!) 10 hours of relaxing nature sounds:  https://www.youtube.com/watch?v=XyTuslmSu_8

Calmers

Put a few drops of lavender essential oil on bedding. (Caution: DO NOT use if your dog has a seizure disorder because lavender oil may be a seizure trigger.) Lavender essential oil has been proven to have a calming effect on laboratory animals. It has to be essential oils, and not lavender fragrance.

DAP Plug in diffuser: DAP = Dog Appeasing Pheromone is the pheromone that is released when a mother dog is nursing her puppies. There have been no scientific studies that have shown that this works, but some owners report a benefit to using DAP, so it is worth trying and isn’t harmful. [editor’s note: Using any oral calmer in combination with a Pheromone diffuser seems to work best. It takes several days for these to start working – it isn’t immediate but they are a much better option if you can avoid heavy duty prescription sedatives such as Acepromazine, Trazodone, etc. Of course always keep your vet in the loop on all things you give your dog.

Use a DAP diffuser with one oral calmer from below:

1- Composure Soft Chews are colostrum based like calming mother’s milk and contain 21 mg of L-Theanine. http://www.vetriscience.com/composure-soft-dogs-MD-LD.php

2-  ANXITANE® S chewable tabs contain 50 mg L-Theanine, an amino acid that acts neurologically to help keep dogs calm, relaxed https://us.virbac.com/anxitane

Prescription medications

If your dog continues to exhibit signs of anxiety like excessive drooling, urinating/defecating in crate (when it is known they have bladder/bowel control) or frantic attempts to escape causing physical injury you may need to discuss with your veterinarian the possibility of prescription medications. Please work with your veterinarian to decide the best medication for your dog taking into account their current medications and health. The following is a list of some medications that your vet may suggest. This is NOT meant to replace your veterinarian’s advice. It is merely a list of some medications that may be used. It is not a complete list.

Plain Benadryl (Diphenhydramine) ask your vet for the dose.

Acepromazine: For any sort of anxiety/fear behavior, this medication is actually NOT recommended by veterinary behavior experts,

Valium (Diazepam), Xanax (Alprazolam): You can ask your vet for a prescription that you can take to a regular pharmacy,

Clomicalm (Clomipramine): a veterinary drug specifically for separation anxiety. It takes 2 weeks for a therapeutic dose to build up in the body.

Potty time how to

Positive Training

Again, use your clicker when you take the dog outside to where it has pottied before or other dogs have (during potty training, do not completely remove all previous potties, so the dog has a mark of where to go). Say the magic words: Go potty and let the dog sniff around. If it goes potty, immediately click and treat. If it took you too long to take the dog outside, and it had an accident inside, use it! Rub a newspaper on it and place it outside to mark where the dog has to go, and take him there on the next potty break. During the entire potty training, do not punish the dog, give him the evil eye, or say harsh words if he has an accident –we’re doing positive training here.

NOTE: A clicker is not the only device that can be used. A small LED keychain flashlight for the deaf (dog should be looking for the flash, not the spot of light. If your dog is watching for the spot, choose something other than a light for your click.)

Cleaning up

Any accidents inside must never be cleaned with an ammonia product, instead use a product specifically designed to clean up urine odor like Natures  Miracle, anti-icky poo, or other enzymatic cleaner that will completely eliminate the source of the odor. An inexpensive option is white vinegar in a spray bottle to clean up urine… removes odor and disinfects.

Use unscented baby wipes for quick clean up on your dog. Optionally boil and cool decaf green tea to dampen a washcloth. It is mild with acidifying, antibacterial properties to neutralize urine on skin and fur. This avoids urine scald plus leaves a clean earthy fragrance.

 

 

Lots more handy member ideas for making the STRICT rest period go smoother: https://dodgerslist.com/2020/05/14/strict-rest-recovery-process/






Disclaimer:

This information is presented for educational purposes and as a resource for the dog IVDD community. The coordinators are not veterinarians or health care professionals. Nothing herein should be interpreted as medical advice and all should contact their pet care professionals for advice. The coordinators are not responsible for the substance and content contained herein and do not advocate any particular product, item or position contained herein.

©2020 Linda Stowe, founder of dodgerslist.com and www.facebook.com/Dodgerslist


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